Intelligent Eligibility, Enrollment, and Customer Support Solutions

Intelligent Eligibility, Enrollment, and Customer Support Solutions

Intelligent eligibility, enrollment, and customer support solutions

Both state Medicaid and Federal health programs must modernize eligibility and enrollment systems for greater cost efficiency and beneficiary service. With the advent of streamlined eligibility processes and Express Lane Eligibility (ELE), states are working to reduce processing time using a quick, simplified method to deliver benefits with both accuracy and speed. It’s imperative to connect special populations and other consumer groups with the right care at the right time.

Cognosante understands these needs and has the experience to support eligibility determination, accurately enter application data, verify eligibility criteria, and implement targeted enrollment strategies.

Intelligent eligibility, enrollment, and customer support solutions

Capabilities include:

  • Application processing focused on accuracy and timely completion, including software-assisted data validation
  • Consumer education and outreach programs designed for specific state demographics and populations
  • In-person enrollment assistance to help states reach, educate, and enroll members, including special populations
  • Accessible, self-service options to help connect members with their healthcare options
  • Extensive knowledge of Federal managed care requirements and awareness of each state’s Medicaid managed care program and unique needs
  • eSante EnGage360®, a multichannel contact solution designed specifically for state and Federal healthcare agencies

eSante EnGage360®

Built on the award-winning Microsoft Dynamics CRM, eSante EnGage360® interfaces with IVR, complex workflow, reporting, and business analytics to provide a comprehensive and cost-efficient solution for state and Federal agencies.

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Case studies

Cognosante helps resolve application and eligibility issues to aid consumers in obtaining health insurance

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